[Plasma levels of folate and vitamin B(12) in patients with chronic liver disease]. / Niveles plasmáticos de la vitamina B(12) y ácido fólico en pacientes con hepatopatía crónica.

BACKGROUND: Patients with liver disease frequently experience changes in their nutritional status. OBJECTIVE: To determine changes in vitamin B12 and folic acid plasma levels in patients with chronic cirrhosis and to assess whether these parameters may be useful in the etiologic diagnosis of this disease. PATIENTS AND METHODS: Thirty-nine patients admitted for decompensated cirrhosis (29 with alcoholic etiology and 10 with non-alcoholic etiology) and 35 controls were prospectively studied. Plasma levels of vitamin B(12), folate acid, mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, and gamma-glutamyltransferase (GGT), among other parameters, were measured. RESULTS: Vitamin B(12) levels were 1151+/-568pg/ml in patients with decompensated cirrhosis and 440+/-133pg/ml in controls (p<0.05). Plasma folate levels were 8.57+/-3.8ng/ml in controls and 6.68+/-2.74ng/ml in patients with cirrhosis (p<0.05). Folate levels were lower in patients with alcoholic cirrhosis (mean value, 5.7+/-2.1) than in those with non-alcoholic cirrhosis (9.3+/-2.6; p<0.0005). The vitamin B(12)/folate ratio discriminated alcoholic etiology better than other parameters such as AST, ALT, MCV, AST/ALT ratio and GGT. CONCLUSIONS: Plasma levels of vitamin B12 in patients with decompensated chronic liver disease are high, whereas plasma folate levels are low. The ratio between vitamin B12 and folic acid may be useful in the differential diagnosis of the etiology of chronic liver disease.

Niveles plasmáticos de la vitamina B12 y ácido fólico en pacientes con hepatopatía crónica / Plasma levels of folate and vitamin B12 in patients with chronic liver disease

IntroducciónLos pacientes cirróticos con frecuencia presentan trastornos nutricionales.ObjetivosValorar en pacientes con hepatopatía crónica los niveles plasmáticos de ácido fólico y vitamina B12 y determinar si estos parámetros pueden ayudar al diagnóstico etiológico de esta enfermedad.Pacientes y métodoSe estudiaron 39 pacientes que ingresan por descompensación de su hepatopatía (29 de etiología alcohólica y 10 por otras causas) y se comparan con 35 controles. Se analizaron, entre otros, los niveles plasmáticos de ácido fólico, vitamina B12, volumen corpuscular medio (VCM), aspartato aminotransferasa (AST), alanino aminotransferasa (ALT), el cociente AST/ALT, la gammaglutamiltransferasa (GGT).ResultadosLos niveles plasmáticos de vitamina B12 en pacientes con hepatopatía crónica descompensada eran de 1.151±568pg/ml y 440±133pg/ml en los controles (p<0,05). Los niveles plasmáticos de ácido fólico fueron de 8,57±3,8ng/ml en los controles y de 6,68±2,74ng/ml en los pacientes con hepatopatía crónica descompensada (p<0,05). Los pacientes con hepatopatía crónica de etiología alcohólica tenían unos niveles plasmáticos de ácido fólico inferiores que los pacientes con hepatopatía no alcohólica (5,7±2,1 frente a 9,3±2.6; p<0,0005). El cociente entre la vitamina B12/ácido fólico discriminaba mejor la etiología alcohólica que otros parámetros analíticos como la AST, ALT, VCM, el cociente AST/ALT y la GGT.ConclusionesLos niveles plasmáticos de vitamina B12 en pacientes con hepatopatía crónica descompensada están altos, mientras que los niveles plasmáticos de ácido fólico están bajos. El cociente entre la vitamina B12 y el ácido fólico podría ser útil en el diagnóstico diferencial de la etiología de la hepatopatía crónica(AU)

BackgroundPatients with liver disease frequently experience changes in their nutritional status.ObjectiveTo determine changes in vitamin B12 and folic acid plasma levels in patients with chronic cirrhosis and to assess whether these parameters may be useful in the etiologic diagnosis of this disease.Patients and methodsThirty-nine patients admitted for decompensated cirrhosis (29 with alcoholic etiology and 10 with non-alcoholic etiology) and 35 controls were prospectively studied. Plasma levels of vitamin B12, folate acid, mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, and gamma-glutamyltransferase (GGT), among other parameters, were measured.ResultsVitamin B12 levels were 1151±568pg/ml in patients with decompensated cirrhosis and 440±133pg/ml in controls (p<0.05). Plasma folate levels were 8.57±3.8ng/ml in controls and 6.68±2.74ng/ml in patients with cirrhosis (p<0.05). Folate levels were lower in patients with alcoholic cirrhosis (mean value, 5.7±2.1) than in those with non-alcoholic cirrhosis (9.3±2.6; p<0.0005). The vitamin B12/folate ratio discriminated alcoholic etiology better than other parameters such as AST, ALT, MCV, AST/ALT ratio and GGT.ConclusionsPlasma levels of vitamin B12 in patients with decompensated chronic liver disease are high, whereas plasma folate levels are low. The ratio between vitamin B12 and folic acid may be useful in the differential diagnosis of the etiology of chronic liver disease(AU)